Chuck Grassley: benefits. so far from socialize ed medicine, it represents the kind of commonsense public-private partnership that ought to be a a-month-old for a greater -- that ought to be a model for a greater health care

Jack Reed: reform. so, mr. president, a lot of families that i've met all across this country are really scared that they're not going to have adequate health care for their kids. the president's response to that was

Jack Reed: just the other day -- i think about a week ago. you know what the president said said? well, they have health care. th can just go to the emergency room. huh... i don't know how many senators have

Jack Reed: been to emergency rooms lately. first of all, they are all over overcrowded. i know that at mass general, which is one of the best hospitals in america, in boston, sometimes they're so oud crowded

Jack Reed: it takes hours to get people to be processed except for the most traumatic that come in. you get people on gurn any ies out in the in the halls, different waiting periods. but it is extraordinary

Jack Reed: what's happened. the degree to which emergency rooms have become the primary care facility for americans is shocking. and hospitalize ed children -- this is important. hospitalize ed children, without

Jack Reed: health insurance, are twice as likely to die from their injuries as those with coverage. and uninsured kids are only half as likely to receive any medical care in a given year. now, mr. president,

Jack Reed: we all go to schools and we talk to teachers and we go p into communities, we have town halls and we listen to voters. i just can't tell you how many times i've heard a teacher tell me how difficult it is

Jack Reed: to teach a whole class of kids, which is usually incidentally an over overcrowded class of kids, where many of those children don't have health care. we know that kids who have health care do 68%

Jack Reed: better in school -- 68% better. and here we are, a country that's struggle ing with an education system that is not keeping up with competitors around the world, we don't graduate enough scientists

Jack Reed: or engineers, researchers, and so forth -- and one of the things that it is actually relate ed to in terms of the choices that children have in their long-term education is whether or not they get health

Jack Reed: care and get screening early. i might also point out, someone who has health care is more like likely to get an early diagnosis of whatever the problem is. if you're a child and you've got got, you

Jack Reed: know, an irregular heartbeat or or a hole in your heart or you have some other disorder, early diabetes set-on or even autistic tendencies -- whatever they are -- if you don't get it a doctor

Jack Reed: and the parent doesn't see those indy indices and isn't able to understand them for for what they might be and get somewhere to get the care, the odds are that child disbog end up costing everybody

Jack Reed: a lot more, not to mention what's going to happen to that child's life. so, mr. president, i hope that colleagues will take a hard look at this. i hope the president will re reconsider his decision

Jack Reed: to veto it. i know that senator baucus and senator rockefeller had negotiated the best bipartisan package that they could and, again, i commend them for doing so. but here on the floor of the senate

Jack Reed: we have an opportunity to work our will as a senate, and we have an opportunity to make a difference different statement. and i believe we ought to be in investing at least $50 billion. thenited states

Jack Reed: senate passed in its budget -- this is in the budget today -- we passed a budget for $50 billion for children's health care. and the only reason it's come to the floor at $35 billion is because

Jack Reed: some people refuse to let it come out of committee or take any shape other than that at this moment in time. so the best way to finance that $15 billion is to do what's fair and to make one of those choices

Jack Reed: that we are called on to me. there are countless choices in this budget. we got 27,000 pages or soavment i think more than that now, of tax code. it fills volumes. and most of those pages do not apply

Jack Reed: to average americans. most of those pages apply to those who've been able to lobby washington, to those who've been able to bring their cows duce this city. this -- to bring their cause to this

Jack Reed: city. this is children and children's lobbies reflect a lot of different organizations. but it seems to me, mr. president, that we have an opportunity to enroll the lowest income, uninsured children by increasing

Jack Reed: the bonus payments that are available to states, so that they meet or surpass their targets. we don't mandate them to do so. we leave the discretion up to states. they have wide discretion with the

Jack Reed: waivers they have today as to how they administered administer these programs and they've prove en themselves very capable and very create ive in doing it. so i hope, as a matter of priority,

Jack Reed: if we really believe it's important to ensure 5 million kids, the same reasons that apply to those 5 million kids ought to apply to the 11 million or 9 million. and t only excuse for not is saying,

Jack Reed: oh, we can't afford that that. and when somebody say, we can't afford that, then you have to low-income look pat what we are choose ing to afford and that is the real test of the balance of what we care

Jack Reed: about and of where we're willing to put our votes.~ i yield the floor. the presiding officer: the senator from iowa. mr. grassley: i rise for two reasons. one, to give the compromise that's before

Jack Reed: the senate defense against senator kerry's amendment, and then to comment on the bill generally, and mostly to comment to some of my fellow colleagues on the republican side of the aisle that i

Jack Reed: consider unfair criticism of this compromise. and i don't rise to find fault with the goals that senator kerry has put forth. i don't even find fault with some of his arguments about loophole closings.

Jack Reed: i might feel compelled to argue against the marginal tax increases that he might want to have. but right now just to concentrate on his view of expanding this compromise and not to question his motives

Jack Reed: or not to raise any question about the sincerity of his wanting to do morexcept maybe if i could reflect on four or five months senator baucus and i have been putting this bill together, we've

Jack Reed: all had some rude awakenings. and those rude awakenings are that what we put together is a $50 billion package and when it was first scored came back much higher than $50 billion. so to get everything

Jack Reed: that everybody wants into $50 billion was very difficult. and the other thing is a philosophy i had that somehow with something less than $50 billion we would be able to coververy kid under 200% of

Jack Reed: poverty, and found out that was not possible. and i'm sure we both from senator kerry's point of view, from my point of view went into this discussion with a good deal of intent and finding out it may

Jack Reed: be a little more difficult than we anticipate. only with that caveat as i ask senator kerry to consider, i now want to say why we ought to defend the compromise that's before the senate. i appreciate

Jack Reed: senator kerry's goal of covering more kids. the bill that we have today ensures 3.2 million kids who don't have coverage today. i'm very proud of that effort, and i'm not going to warm to any suggestion

Jack Reed: that we have not done enough. the finance committee bill does so through a new incentive fund, and it's a proposal that has both sides of the aisle supporting. it is a compromise. the incentive

Jack Reed: fund is a product of months of work. we built on ideas that were formed by another bipartisan couple, senator rockefeller, on the one hand, for democrats; senator snowe, on the other hand, for republicans.

Jack Reed: we took those ideas that senator rockefeller and senator snowe had and reshaped them in what we think represents a very efficient and cost-effective way to increase coverage for children. as the senator

Jack Reed: may recall, during the markup -- and i'm referring to senator kennedy, or senator kerry. he may recall during a markup of the senate finance committee, the congressional budget office director characterized

Jack Reed: the incentive fund as -- quote -- "as efficient as you can possibly get per new dollar spent." simply throwing money at states is not an effective strategy for covering more kids. cost is an object.

Jack Reed: the bill that is moving in the house does not cover a million more kids that are not currently covered in the senate bill -- no, i said that wrong, mr. president. the house bill does cover a million

Jack Reed: more kids that are not currently covered by the senate bill. but they do so while spending $12.2 billion more than we do, getting back to the efficiency and effectiveness statement of the c.b.o.

Jack Reed: director, peter orzog. i'll leave my colleagues to decide for themselves whether they think $12.2 billion for a million kids is cost effective. but i can assure you that the cost will leave us then, if we did

Jack Reed: that, without a bipartisan bill and maybe not the chance of getting anything through other than extension. and i've stated even from our republicans, who don't like the waiver process, that that's

Jack Reed: bad policy. the finance committee bill then -- i'm begging senator kerry to understand -- is the best of the possible. the last wants more. the right wanted a lot less. we can make speeches or make

Jack Reed: legislation. making speeches does not get any kids covered. making legislation does. and our compromise does that. i urge my colleagues to keep on the right track for making legislation, and that's doing

Jack Reed: the art of the possible. i opposehis amendment and urge my colleagues to do the same. now, mr. president, i'd like to speak on the bill. and i want to start out by referring to what i hope we have a chart

Jack Reed: here that's been used by a lot of republican colleagues over the last two or three days. and this is speeches that were given yesterday by many of my colleagues who are sincere in their approach. they

Jack Reed: want you to see -- they refer to this as a cliff chart. everything to the right of the green is after this legislation expires. and they want you to believe that we don't take into consideration anything

Jack Reed: about the future. so they're making out that this is an unrealistic proposal we have before you because following that red line up into the future, it is going to cost more than we can afford. and i want

Jack Reed: to say how this approach is intellectually dishonest. i have a tremendous amount of respect for the senators who have been giving these speeches, and i can identify a couple. there's probably more that have been

Jack Reed: giving these speeches. but i want my colleagues to know that i respect senator gregg, the ranking republican on the senate budget committee. and senator trent lott, i think, has referred to this. the senator

Jack Reed: from mississippi is our assistant minority leader, and i respect his views. but i think everybody ought to take into consideration here what we're going to do, and i have a chart that is going to

Jack Reed: lay this out in just a minute. in this particular instance we clearly are on different sides of this argument. there has been a lot of talk around here about how the senate finance committee bill is

Jack Reed: funded, and this chart was used in that discussion. and taking a hard look at how bis are financed is a good thing. maybe we don't do that often enough. so let me focus on the criticism that has

Jack Reed: been made about how this schip bill is financed. we need to step back. we need to look at the whole picture. that's what i'm begging my colleagues to do. the schip program is a pretty small part of

Jack Reed: that picture. the thing about schip is that it is not like medicaid or medicare. and how many times have you heard the people using this chart refer to like it's an entitlement? it is not an entitlement

Jack Reed: that we're discussing today. or maybe if people don't understand the term "entitlement," it's not a permanent program like medicare and medicaid are, because they are entitlements. schip is not. so

Jack Reed: when the program expires, it truly ends. the day after the authorization ends, poof, there's no more schip program. that's true of any program that sunsets. but medicare and medicaid don't sunset. they're entitlements.

Jack Reed: schip is reauthorized for five years. that's five years on top of the original ten years that was authorized. so this year it's sunsetting. that's not an entitlement. it's an expiring program. i know that

Jack Reed: most of us in this chamber would no sooner let the department of defense expire than we would let schip expire. that is a simple fact. and because it is an expiring program, it is subject to a

Jack Reed: very particular budget rule, and that budget rule does not fit this chart. that budget rule says the congressional budget office must score future spending for the program based upon last year of the

Jack Reed: program's current authorization. so the baseline for schip for the next year is $5 billi. that's under existing law. if we pass this legislation, that wouldn't be true. but for what is law right now,

Jack Reed: in the future they're going to score that as $5 billion. for the next five years, the baseline, let me say again, is $5 billion. for the next ten years, the baseline for schip is $5 billion. it

Jack Reed: is actually $5 billion a year forever. does anyone in this chamber think that the budget rule governing schip is realistic? well, of course it's not realistic, but that's the way the budget process

Jack Reed: and the budget office must work under existing law. so i'm not here to kid anybody. according to the congressional budget office, 1.4 million children would lose coverage if we simply reauthorize schip

Jack Reed: at the baseline of $5 billion into the future. who among us would go home and tell our constituents that we individually voted to reauthorize the schip program, reauthorize it, yes. if you stopped

Jack Reed: there, they'd think, well, you did a good thing. what you're doing right now, you continue to do. you know if you did that what you'd be doing without telling them, but they'd soon find out. you don't

Jack Reed: fool the american people. 1.4 million kids would lose coverage. so when the finance committee went to work to reauthorize this bill, as senator baucus and i, with the help of senator hatch and rockefeller,

Jack Reed: we had this problem: the baseline only assured $5 billion a year in spending into the future. it was unrealistic. let me digress and point to a problem that the agriculture committee has this year

Jack Reed: exactly the same way. we didn't spend all the money in the agriculture bill last year, and so we're working on a baseline that's $15 billion less than it was in 2002, the last time we wrote a farm bill. so

Jack Reed: this isn't just a case of health care for kids. a lot of committees get caught this way. but we do have the realistic fact that costs continue to increase in schip even though the $5 billion was frozen

Jack Reed: in the baseline because of the budget rules. so what did we have to do? we had to come up with the money just to keep the current program afloat. that meant that we had to find at least $14 billion

Jack Reed: just to keep the current program afloat. that's right. of the $35 billion in funding in this bill, $14 billion is put into the schip just to maintain the current program. that's $14 billion just to

Jack Reed: maintain coverage of kids who are currently enrolled. and you know what the white house wanted us to believe all this year since they submitted their budget? that you could do that $14 billion, maintaining

Jack Reed: the current program for the $5 billion that they put in their budget. those people down at o.m.b. have got to be smart enough in advising the president that you can't do $5 billion, a policy of doing what

Jack Reed: we're doing now and even expanding a little bit for $5 billion when in fact it costs $14 billion. and to a very real extent, this is the same kind of situation that my good friend from new hampshire,

Jack Reed: senator gregg, when he was speaking, is complaining about. the current baseline was not realistic. that created a hole in the budget that we had to fill. in our case, it was a $14 billion hole to fill if

Jack Reed: you want to maintain current policy. so what did we do?~ you do what you have to do if you are responsible and deliver on what you say you're going to do. we filled it. it's that simple. we had to

Jack Reed: come ploy with the budget rules. what people forget around here is that the director of the c.b.o. is like god and everybody works if the budget works in the budget fs budget office can be little

Jack Reed: gods. what they say you have to follow and you have to have the impossible, get 60 votes to get around it. should they have that much power? if you have budget discipline they have to have that

Jack Reed: kind of power. but it's just that simple. we had to fill that hole. we had to comply with the budget rule. so we did. did those budget rules make sense? well, i think i've indicated they probably don't

Jeff Sessions: but that's a question for the budget committee to answer. senator gregg's committee, senator conrad's committee, not the finance committee. we have to abide by it. there's another budget rule that the finance